WASHINGTON (AP) -
The Supreme Court on Thursday upheld the nationwide tax subsidies
underpinning President Barack Obama’s health care overhaul, rejecting a
major challenge to the landmark law in a ruling that preserves health
insurance for millions of Americans.

The justices said
in a 6-3 ruling that the subsidies that 8.7 million people currently receive
to make insurance affordable do not depend on where they live, as opponents
contended.

The outcome was the
second major victory for Obama in politically charged Supreme Court tests of
his most significant domestic achievement. And it came the same day the
court gave him an unexpected victory by preserving a key tool the
administration uses to fight housing bias.

Obama greeted news
of the decision by declaring the health care law “is here to stay.” He said
the law is no longer about politics, but the benefits millions of people are
receiving.

Declining to
concede, House Speaker John Boehner of Ohio said Republicans, who have voted
more than 50 times to undo the law, will “continue our efforts to repeal the
law and replace it with patient-centered solutions that meet the needs of
seniors, small business owners, and middle-class families.”

At the court, Chief
Justice John Roberts again voted with his liberal colleagues in support of
the law. Roberts also was the key vote to uphold it in 2012. Justice Anthony
Kennedy, a dissenter in 2012, was part of the majority on Thursday.

Limiting the
subsidies only to individuals in states with their own exchanges could well
push insurance markets in the other states “into a death spiral,” Roberts
wrote.

Justice Antonin
Scalia, in a dissent he summarized from the bench, strongly disagreed. “We
should start calling this law SCOTUScare,” he said, using an acronym for the
Supreme Court and suggesting his colleagues’ ownership by virtue of their
twice stepping in to save the law from what he considered worthy challenges.

His comment drew a
smile from Roberts, his seatmate and the object of Scala’s ire.

Scalia said that
Roberts’ 2012 decision that upheld the law and his opinion on Thursday “will
publish forever the discouraging truth that the Supreme Court of the United
States favors some laws over others, and is prepared to do whatever it takes
to uphold and assist its favorites.”

Justices Samuel
Alito and Clarence Thomas joined the dissent, as they did in 2012.

Nationally, 10.2
million people have signed up for health insurance under the Obama health
overhaul. That includes the 8.7 million people who are receiving an average
subsidy of $272 a month to help pay their insurance premiums.

Of those receiving
subsidies, 6.4 million were at risk of losing that aid because they live in
states that did not set up their own health insurance exchanges.

The health
insurance industry breathed a big sigh of relief, and a national
organization representing state regulators from both political parties said
the court’s decision will mean stable markets for consumers.

“This decision
allows (state officials) to move forward with a level of confidence that
their markets will not see significant disruption due to a paradigm shift,”
said Ben Nelson, CEO of the National Association of Insurance Commissioners
and a former Democratic senator from Nebraska.

Shares of publicly
traded hospital operators including HCA Holdings Inc. and Tenet Healthcare
Corp. soared after the ruling relieved those companies of the prospect of
having to deal with an influx of uninsured people. Investors had worried
that many patients would drop their coverage if they no longer had tax
credits to help pay.

The challenge
devised by die-hard opponents of the law relied on four words - “established
by the state” - in the more than 900-page law.

The law’s opponents
argued that the vast majority of people who now get help paying for their
insurance premiums are ineligible for their federal tax credits. That is
because roughly three dozen states opted against creating their own health
insurance marketplaces, or exchanges, and instead rely on the federal
healthcare.gov to help people find coverage if they don’t get insurance
through their jobs or the government.

In the challengers’
view, the phrase “established by the state” demonstrated that subsidies were
to be available only to people in states that set up their own exchanges.

The administration,
congressional Democrats and 22 states responded that it would make no sense
to construct the law the way its opponents suggested. The idea behind the
law’s structure was to decrease the number of uninsured. The law prevents
insurers from denying coverage because of “pre-existing” health conditions.
It requires almost everyone to be insured and provides financial help to
consumers who otherwise would spend too much of their paycheck on their
premiums.

The point of the
last piece, the subsidies, is to keep enough people in the pool of insured
to avoid triggering a disastrous decline in enrollment, a growing proportion
of less healthy people and premium increases by insurers.

Several portions of
the law indicate that consumers can claim tax credits no matter where they
live. No member of Congress said that subsidies would be limited, and
several states said in a separate brief to the court that they had no
inkling they had to set up their own exchange for their residents to get tax
credits.

The 2012 case took
place in the midst of Obama’s re-election campaign, when Obama touted the
largest expansion of the social safety net since the advent of Medicare
nearly a half-century earlier. But at the time, the benefits of the
Affordable Care Act were mostly in the future. Many of its provisions had
yet to take effect.

In 2015, the
landscape has changed, although the partisan and ideological divisions
remain for a law that passed Congress in 2010 with no Republican votes.